Plantar fasciitis is a common cause of heel pain. It is inflammation of the plantar fascia, the connective tissue on the bottom of the foot extending from the heel bone to the base of your toes. When there is tension on the fascia, it can cause small tears. Repetitive stress to the area increases the irritation which leads to an inflammatory response. Some of the most common cause are…

Distance running (especially with inappropriate or old shoes)

Flat feet or high arches

Abnormal gait

Obesity

Tight calves

Wearing high heels

Standing on your feet all day

Feet that roll in (excessive pronation)

SYMPTOMS:

The most classic symptom is stabbing pain on the bottom of the foot, near the heel with the first few steps after getting out of bed OR after sitting for a long time. Pain is also common with climbing stairs.

TREATMENT:

Early on:

Ice for 10 minutes, 3-4 times a day

Decrease activity. If you are a runner you may need to stop running completely for a few weeks.

Anti-inflammatory medication

Use a night splint to keep the fascia stretched while you sleep to help reduce the “first step” pain

Wear a heel wedge in your shoe to decrease plantar fascial strain when standing. Make sure the thicker part of the wedge is on the inside of your foot.

After the acute phase:

Deep tissue massage helps to encourage blood flow and break up adhesions. You can initiate this by rolling a golf ball or frozen water bottle under your foot. It is also helpful to have a massage therapist perform deep tissue massage to your calf.

Gentle stretching of the calf: Keep toes of both feet pointing forward and back knee straight. Hold for 30 seconds. Repeat 3 times.

Towel scrunches: Put a small towel on smooth floor (not carpet). Sit on a chair with the affected foot flat on the towel. Your foot should be directly under your knee. Grab the towel with your toes and release. Do 10-15 repetitions twice daily.

Unfortunately, once you have plantar fasciitis it can take several weeks and up to several months to resolve. Its important to continue your treatment throughout the process. If your symptoms worsen or do not appear to be resolving after 3-4 weeks of trying the above suggestions it may be necessary to seek treatment from a physical therapist. Don’t lose heart. Eventually it WILL get better.

Carpal tunnel syndrome. Everyone has heard of it but you may not really know what it is. Basically, it's entrapment or compression of the median nerve in your wrist. The carpal tunnel is a passageway in your wrist. The median nerve extends from the palm side of your forearm down to your wrist through this passageway. Anything that compresses the nerve or narrows the tunnel can lead to carpal tunnel syndrome. Often, it is more than one thing that is causal....

CAUSES AND RISK FACTORS:

Repetitive Movements/Overuse: computer work, knitting, writing, working with vibrating tools and any other activity involving use of the hands for extended periods of time.

Small carpal tunnels due to genetics or a fracture/dislocation that has altered the space.

Posture: head and neck position can stress nerve roots and refer symptoms farther down the arm.

Numbness, tingling or burning in the thumb and first 3 fingers is the hallmark sign. Especially in the index, middle fingers and half of the ring finger (the half closest to the other two fingers). People often wake at night due to numbness and burning.

Other symptoms can include pain, loss of grip strength and dropping objects.

If left untreated for a long time, you may notice muscle wasting at the base of the thumb.

TREATMENT AND PREVENTION:

Wear a wrist brace like this or this to help hold the wrist in a neutral position, while sleeping.

Take frequent breaks and stretch while performing activities that aggravate your symptoms.

Assess your posture. Are you hunched over a computer or slouched with your head forward? Talk to a physical therapist about changes you can make to your work station.

Surgery. If you are considering surgery, I would highly recommend you get more than one surgical consult. Many different specialists perform this surgery: orthopedic surgeons, neurosurgeons, and plastic surgeons. CAUTION: If pain is your only symptom, surgery will most likely NOT resolve your symptoms and can actually make it worse due to residual scar tissue. Those who have the best results from surgery have significant numbness and weakness to the extent their quality of life is affected.

EXERCISES YOU CAN DO FOR PREVENTION AND SYMPTOM REDUCTION:

All of these exercises should be done gently. You should feel a mild to moderate stretch but no pain. If it hurts, back off a little.

SHAKE IT: Just like it sounds, periodically throughout the day, shake your hands for a few seconds as if they are wet and you are trying to get the water off.

EXTENSOR STRETCH: Place one arm out in front of you with your hand out straight and palm down. Use your other hand to gently apply pressure to the back of the hand so that fingers point to the floor. Hold for 20 seconds. Repeat 2-3 times.

PRAYER STRETCH: Start with your palms together at your chest, fingertips just below your chin. Keeping your hands close to your body and palms together with fingers pointing to your chin, gently lower your hands until you feel a gentle stretch on the underside of your forearms. Hold 20-30 seconds. Repeat 2-3 times.

FLEXOR STRETCH: Place your arm out in front of you with your hand straight and with your palm UP. With your other hand, gently pull your hand down so the fingers point to the floor. Hold 20 seconds. Repeat 2-3 times.

I hope this post has been helpful. If you have ever had carpal tunnel syndrome please share what has been helpful for you.